If you exercise, please provide Strength Training details below (type of exercise, amount of resistance, number of sets and repetitions performed)*

How would you rate your eating habits?*

1 (significant room for improvement)

2 (some room for improvement)

3 (I’m a super star!)

How willing are you to make the needed tweaks to your eating habits to support our work for your goals?*

1(it will be very hard for me)

2 (A challenge I am ready to work on)

3 (I’m all in!)

All are required

What is the main reason that compelled you to start this training?*

How do you picture yourself 3 months from now physically?*

How do you picture yourself 3 months from now emotionally?*

How do you picture yourself one year from now physically?*

How do you picture yourself one year from now emotionally?*

What are the primary goals you would like to reach with your exercise program (genral strength, fat loss, flexibility, sports training, improve a specific body part, sport/skill, low back strength, etc. Please be as specific as possible):*

How ready are you to do what it takes to commit to these goals?*

1(it will be very hard for me)

2 (A challenge I am ready to work on)

3 (I’m all in)

What do you foresee as your biggest challenge?*

If you had to give 3 keywords you need to feel in order to be successful, what would they be?*